A puffed-up scare over menthol cigarettes

The EU’s proposed ban exposes the myth of ‘evidence-based’ policy.

I

7 October 2013

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If someone were to tell you that the European Union was about to ban the MMR vaccine over emotional reports that it causes autism, you would rightly think that the folks in Brussels had lost the plot and succumbed to overwrought and unsubstantiated rumour.

Yet, tomorrow (Tuesday 8 October), a plenary is being held in Brussels where MEPs will be voting on the Europe-wide prohibition of menthol cigarettes - a policy no more rooted in evidentiary science than the now debunked myths which were presented during the MMR scare.

There are a plethora of misconceptions about menthol that the anti-tobacco lobby has seized upon to railroad the EU down a path not only deeply illiberal, as argued by Ben Lazarus on spiked last month, but also do not add to the aspiration of improved public health and tobacco harm reduction.

The main fake concern – a favourite of shroud-waving prohibitionists everywhere – is towards children. In this case, the claim is that a soothing minty flavour seduces youngsters more than a harsh tobacco taste. But the EU is also grounding its stance on a false fear that menthol cigarettes can be more difficult to quit, and even that they are disproportionately harmful compared with standard blends. However, not one of these justifications stands up to serious scrutiny.

It is an easy mistake to make, though. In the USA, the Food and Drug Administration (FDA) was initially suckered into the same mindset when considering bans on all tobacco flavourings. However, it altered its approach when coming up against the inconvenient obstacle of strong evidence against the case for a ban on menthol-flavoured cigarettes. This was not attributable to some altruistic change of heart from a benevolent state, more that across the Atlantic, menthols are consumed by a large proportion of black American smokers, making it something of a race issue that the FDA was forced to look at very carefully.

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When it did, the regulator found that legislative zeal was premature, since adding menthol to tobacco in the US does not increase harm from smoking. It was decided that far more evidence would be required before offering conclusions as to menthol’s effect on uptake and quit rates.

In fact, while a large majority of African Americans favour menthol cigarettes, they are amongst the demographic which has enjoyed the steepest declines in smoking prevalence. Other prominent menthol users – women and adolescents – are also far more likely to quit than smoking sub-groups for whom menthol is less common. Moreover, the proportion of African American youths who smoke is dramatically less than their white counterparts, despite – or perhaps because of – the much higher prevalence of menthol smokers.

When an FDA scientist further found that menthol smokers enjoyed a reduced chance of dying of lung cancer across all age ranges, sexes and ethnicity compared to smokers of non-menthol products, the FDA dispensed with kneejerk adherence to myth lobbyists and instead committed to an exhaustive evidence-based approach which is still ongoing. Menthol has now been exempted from the FDA’s flavouring ban pending this research, mirroring a similar decision in Canada, where Department of Health minister Paul Glover – in excluding menthol from their own legislation in 2009 - declared menthol flavouring ‘not something youth find attractive’.

Despite all this real-life evidence, the EU is stubbornly unmoved. By contrast, it has not followed an evidence-based approach and has certainly not been transparent as to what is guiding its proposals. With respect to the scientific debate there has been no opportunity for anyone but the powerful European anti-tobacco lobby to comment.

Buried in an impact assessment that details the EU’s case (a document notably light on independent evidence) the real driver seems clear. The authors declare that there is an ‘absence of a harmonised approach under the current situation’ which ‘has led to enforcement of national rules … becoming more burdensome’. Translated, this means that the EU bureaucrats are disappointed that not one of the 28 member states has ever proposed banning menthol cigarettes, so the determined plan is to usurp sovereign lawmaking and compel each and every one of those countries to do so.

Perhaps the reason that – unlike the US, Canada and Brazil – evidence has been actively avoided by the EU is that Eurocrats know very well that it makes their ban on menthol appear as naïve as outlawing unicorns.

Amongst EU states, Finland has the largest percentage of menthol smokers at 25 per cent, and Greece has the smallest proportion, at 0.1 per cent. Yet EU statistics show that Finland also enjoys one of the highest quit rates in the EU, while Greece has the highest smoking rate by quite a margin.

Evidence aside, the EU will also be ignoring its own advisers simply by offering up the policy for a vote. Five of the six advisory committees rejected a ban on menthol for a number of valid reasons.

For example, the Committee on the Internal Market and Consumer Protection (IMCO) declared: ‘There is no sufficient evidence that menthol has a bad influence on the smoking behaviour among youngsters’ and recommended menthol ‘should not be classified with the other flavoured tobacco products’.

Faced with an avalanche of reasons not to implement a ban which binds 28 countries without a democratic mandate from their citizens, it is disappointing that MEPs may blindly vote in favour of a measure which is deeply illiberal, not rooted in science, not supported by the EU’s expert committees, potentially subverts efforts to reduce smoking prevalence, and is correctly being scrutinised more astutely in other countries.

When policies such as this - in direct contravention of every control a free society holds dear - are proposed by the EU, we should be very worried, smoker, non-smoker or menthol enthusiast alike. For if the ban is approved, around one million British smokers – and many times that number elsewhere in the EU – will be deprived of their menthols, creating a lucrative new avenue for criminal black marketeers where none had felt the market large enough to cater for previously.

In voting to ban menthol, MEPs may believe that they are striking a blow for public health, yet all the evidence shows that there is nothing to be gained from an illiberal ban which will inconvenience millions of European citizens. Instead, the EU could do no worse than to look at the objective way that the US FDA is scrutinising the effects of menthol cigarettes, rather than rushing into prohibition over fears which are as irrational as worrying about monsters in the wardrobe.